3440.10 with Changes - Navy Medicine - U.S. Navy

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Element 1 Element 2 Element 3 Element 4 Element 5 Element 6 Element 7 Element 8 Element 1 Element 2 Element 3 Element 4 Element 5 Element 6 Table 6.2 Required Elements for Long-Term Exceptions Requests BVMEDINST 3440.10 CH-2 25 Apr 2012 Full name and VIC ofthe requesting MTF Statement of the long-term exception requirement and references to the standard and page/paragraph in this instruction that cite the standard that cannot be met Specific description of condition(s) that caused the need for the permanent exception and reason(s) why applicable standards in this manual cannot be met Identify interim mandatory compensatory measures in effect or planned Describe the impact on mission and any problems that will interfere with safety or operating requirements if the long-term exception is not approved Identify resources, including estimated cost from which budgeting decisions can be made, to eliminate the long-term exception Identify actions initiated or planned (local capability or other) to eliminate the long-term exception and estimated time to complete Provide point of contact to include name, rank/grade, DSN, and commercial phone numbers Table 6.3 Format for Requests for Permanent Exceptions Full name and VIC of the requesting MTF Statement of the permanent exception requirement and reference to the standard and page/paragraph in this instruction that cite the standard that cannot be met Specific description of condition(s) that caused the need for the permanent exception and reason(s) why applicable standards in this manual cannot be met Identify, in detail, compensatory security measures that are being applied Describe the impact on mission and any problems that will interfere with safety or operating requirements if the permanent exception is not approved Provide point of contact to include name, rank/grade, DSN, and commercial phone numbers 43 Enclosure (1)
From: To: Via: SAMPLE WAIVER REQUEST BUMEDINST 3440.10 CH-2 25 Apr 2012 3440 Serial Date Officer in Charge, Naval Branch Health Clinic, Naval Air Station Jacksonville, FL Chief, Bureau of Medicine and Surgery (M3) (1) Commanding Officer, Naval Hospital Jacksonville, FL (2) Commander, Navy Medicine East Subj: REQUEST FOR WAIVER TO NAVY MEDICINE FORCE HEALTH PROTECTION EMERGENCY MANAGEMENT PROGRAM Ref: (a) BUMEDINST 3440.10 Encl: (1) Waiver Request in case of Naval Branch Health Clinic, Naval Air Station Jacksonville 1. In accordance with reference (a), enclosure (1) is submitted for consideration. J. A. SAILOR 44 Enclosure (1 )
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3440.10 with Changes - Navy Medicine - U.S. Navy

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